MichPHA Regional collaborations of health plans, employers and hospital delivery systems across the country are engaging in projects not only to improve the delivery of quality health care, but also to do so in a manner that is effective and efficient. Employer groups realize that quality and cost must be simultaneously addressed in deciding where to spend their health care dollars. Employers need assistance in the form of "tools" to help guide decisions to a value-based (consideration of cost and quality of process and outcomes) equation. Historically, it has been left to larger employers and business coalitions to develop and implement Value Purchasing tools, including Value-Based Benefit Design (VBBD). In confluence with AHRQ's mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans, The Michigan Purchasers Health Alliance (MichPHA) seeks grant support for a [Q1 2011] agenda-building and dissemination workshop focused on the role that the combination of quality and efficiency - value - can play in the design and purchase of employer-based health insurance. MichPHA will convene a workshop to disseminate important evidence-based knowledge gleaned about value purchasing from larger groups, to discuss the pragmatic application of such knowledge in the context for small and mid-size groups, and to develop a potential plan for action for participants and researchers that will extend the knowledge beyond attendees and generate research to fill identified gaps in knowledge. By assembling researchers, small to mid-sized businesses and quality thought leaders, the conference will bring together the very participants who will need to collaborate to implement the research agenda and extend conference findings to other audiences. Among specific topics to be presented and discussed are: Value- Based Purchasing (VBP) what we know that works;Practicality of applying VPB to small/mid-sized employers;and Identification of barriers. Given that the demographics of small/mid-sized employers include a significant percentage of women and minorities, some special attention will be focused on the intersection of value purchasing for these relevant AHRQ priority populations. The final report will distill the conference deliberations in the form of a research agenda highlighting the identification of top priority research questions and barriers to implementation, conference attendee consensus on effective strategies and next steps for willing partnerships. A summary will be posted on the MichPHA website and be made available for broader dissemination through The National Business Coalition on Health (NBCH), the national, non-profit membership organization of purchaser-led health care coalitions. NBCH will be an active participant in the conference and an important 'next steps'partner with MichPHA. PUBLIC HEALTH RELEVANCE: Relevance Our health care system is designed to address illness or injury because for many years care was focused on providing acute interventions. The current shift is to preventive care, wellness programs, and focused chronic care management. Value Based Purchasing (VBP) and Value-Based Benefit Design (VBBD) is an essential component to maintain that shift with the goal of a healthy, productive workforce and community.